Provider Demographics
NPI:1740403948
Name:CHUN, DENNIS PO (DDS)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:PO
Last Name:CHUN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 LOCUST ST
Mailing Address - Street 2:APT#203
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1680
Mailing Address - Country:US
Mailing Address - Phone:626-578-1855
Mailing Address - Fax:
Practice Address - Street 1:748 LOCUST ST
Practice Address - Street 2:APT#203
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1680
Practice Address - Country:US
Practice Address - Phone:626-578-1855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA507431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice